The Joys of Dealing With Bladder Incontinence - Urodynamic Testing by Lois Casson - Personal - http://maxpages.com/happymspage/Bladder_Disfunction_part

There is really nothing funny about MS,
but sooner or later all of us with the
disease realize that the only way to get
through awkward and embarrassing situations
is with a well-developed sense of humor.
Unfortunately, I had not done that the
evening my bladder gave way while I was in
the super market.I was very angry as I
pulled my jacket down and hurried out of
the store.
I saw my neurologist who emphasized the
need to see a urologist.I was very bitter
so I told my urologist that this was the
"ultimate Degration"Not!!!!little did I know
that the worst was still to happen.

A couple years ago prior to becoming incon-
tinent I had seen the urologist because of
urgency.He had done some urodynamics testing
in his office, a relatively simple proceedure
at the time.Afterwards he told me that a lot
of people with "my problem" have to self-
catheteerize. I didn't fully understand what
"my problem" was ,MS hadn't entered the
picture yet, I only knew that I would never
self-catheterize and told him so.

Once again I was scheduled for urodynamics
testing, but instead of having it done in the
doctor's office,I had to go to the hospital
for a proceedure far more sophisticated than
the office test. The first thing i had to do
was take everything off from the waist down.
I had to put on paper slippers so that I didn't
get my socks wet.
After empting my bladder in the toilet chair
(they measure the urine)I hadto lay on an X-ray
table while I was catheterized to measure for
residual urine. Then the fun begun.I felt I was
being wired for sound as they stuck probes here,
there and etc.THe worst was one that felt like
they were cramming a nail into the perineal area,
the space between the anus and the vagina or
scrotum. After this preparation was completed,they
then raised the table to the upright position.
(subsequent testing used a hydraulic chair like
a birthing chair.)

As I stood and watched a fluoroscope screen
my bladder was being filled from a bottle of
normal saline. (sterile salt water)
Another computerized gaget was measuring the
pressures reported by the various probes attached
to all of the muscles involved with urinary
control and evacuation.The objective I was told
was to replicate an episode of incontinence in
order to determine exactly what was happening.
In women, incontinence can be related to damage
done during child birth. For this reason the
testing evaluates the function of your bladder,
urethra and urinary sphincter.

Though they don't always succeed in producing
an episode of incontinence, I did wet my paper
booties. The testing also demonstrated that I
was experiencing bladder spasms as well as spasms
of the uretha and urinary sphincter, a common
problem in MS. What this mentt is that my
bladder could not empty adequately because the
spinctor didn't relax sufficently. When my bladder
become too full it too went into spasms basically
overriding the resistance in the urethra and
urinary sphincter.

For most people, this diagnosis means taking
antispasmodic medication, Ditropan or Levsin
or others, to allevate the bladder spasms, and
intermittent self-catheterization to fully empty
the bladder. Because my urologist is a uro-
dynamics specialist and able to do bladder
augmentation surgery, he recommended the surgery
to enlarge my bladder when efforts to dilate the
urethra and the sphincter to allow adequate
emptying failed.This has left me almost totally
dependent on catheterization to empty my bladder
but eliminated the need for medication and all
the nasty side-effects, a fair trade.

i didn't jump into the surgery. I took several
months to adjust to the reality that with or with-
out it, my bladder function was permanently changed.
(There was a ten month period between the onset of
incontinence and the surgery, but the bladder spasms
preceded that by at least two years.) I even asked
the urologist if he was recommending the surgery
because he really thought it would be an improve-
ment or just because it was something he could do.
He told mr that I had three choices. I could leave
things as they were and stick with medication and
catheterizeing; he could do an ostomy, an opening
through the abdominal wall to a bag attached on
the outside to your skin; or I could have the
bladder augmentation and continue cathing. In the
end, the augmentation was the best choice.

The subject of catheterization is one not often
discussed in live support groups,so many people
don't know how common it is amongst PWMS.
I have found that it is very convenient to be
able to completely empty my bladder and then go
up to six hours without another trip to the
restroom. It is also surprisingly easy to do
for most men and women. Those who have difficulty
are those who have problems with the function of
their hands. And ,like all the other problems
related to my MS, I've adjusted and gone on with the business of living.... isn't that what we all have
to do?

Eileen Lukeman and Richard Tanner

FL.

Eileen(Lobosgirl) and Richard (RET1000) both at aol.com

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Page Updated Wed May 7, 2008 9:45am EDT